A survivor hen that was not expected to live

On Thanksgiving Day, we thought that a young chicken (3-month old) had healed enough to finally release from isolation.  I'm glad that despite her being scared, the other chickens didn't bully her.  I hope that holds true tomorrow.

She was attacked by something we never figured out while she was inside the run. This hen was badly injured a couple of months ago that the vet suggested over the phone to euthanize her. We didn't have the heart to do it so we tried to bandage her up. Her gizzard was torn off that the food and water was leaking and her sides had been ripped open along her full length. But look at her now. This is her first time outside her cage since the attack 2 months ago.  This is one of the small things for which we should be thankful.

Only three embryos survived on Day 5

Out of the five embryos on day 3, only three had made it to day 5 blastocysts.  I’ve been told that this is at par of what the norm is – exactly what they expected.  I’m a bit sad the other two didn’t survive even though they are just a cluster of cells.  But thank you Lord three made it up to this point.

My three blastocysts are graded as follows which are pretty good:

Blastocysts	Grading
1	5AA
2	4AB
3	4BB

To understand how the grading system works, I googled and here’s what I found from http://www.advancedfertility.com/blastocystimages.htm

The Gardner blastocyst grading system assigns 3 separate quality scores to each blastocyst embryo:

1. Blastocyst development stage - expansion and hatching status
2. Inner cell mass (ICM) score, or quality
3. Trophectoderm (TE) score, or quality

Expansion grade	Blastocyst development and stage status
1	Blastocoel cavity less than half the volume of the embryo
2	Blastocoel cavity more than half the volume of the embryo
3	Full blastocyst, cavity completely filling the embryo
4	Expanded blastocyst, cavity larger than the embryo, with thinning of the shell
5	Hatching out of the shell
6	Hatched out of the shell

ICM grade	Inner cell mass quality
A	Many cells, tightly packed
B	Several cells, loosely grouped
C	Very few cells

TE grade	Trophectoderm quality
A	Many cells, forming a cohesive layer
B	Few cells, forming a loose epithelium
C	Very few large cells

A “perfect” day 5 embryo would be a 4AA.  But many pregnancies do occur from AB or BB quality embryos. 

And I took this pictures from the internet to see what a grade 4AA blastocyst looks like since I'm a visual person.

So right now, our 3 blastocysts are frozen.  Our clinic is using the more advanced method called vitrification and at first I was worried about this ‘freezing’ process but I was told it has over 98% survival rate.  The older method was slow freezing can do more damage to the embryo and they don’t do that at all at the clinic.

Also biopsies have been taken from our 3 blastocysts and is being sent to U.S. for PGS (Pre-Implantation Genetic Screening). I’m praying that at least one or all three of them come back as chromosomally normal.  We have only 3 and it’s a bit scary…

So here's the summary so far.

Follicles: 16

 Eggs: 11

 Mature eggs: 7

 Fertilized: 6

 Made it to day 3/5:  Five made it to day 3 and three made it to day 5 blastocysts

 Fresh or FET: Frozen (since we’re waiting for the PGS genetic testing results)

 Transfer date: most likely mid-November if the genetic test results come back normal and my uterine lining is thick enough by then.

 How many transferring: 1 (praying hard it will happen and will stick)

IVF Journey so far up to Day 3 embryo

This blog is a deviation from my usual chicken ranting.  I was hesitating at first whether I should blog about our IVF journey.  But I need an outlet and keep a journal of this important life event.  And hoping this would help young couples to think twice about delaying getting pregnant as it becomes more difficult to conceive as you age.

When we moved to the farm full time 2 years ago, I thought I already had a closure that having a child was not for us.  So we adopted 2 dogs (Baloo and Louie) then had lots of chickens and 7 ducks. 

 

Last January of this year, I was ecstatic when the Ontario government announced that they will fund one round of IVF for women 42 years old or under.  I immediately signed up at the fertility clinic recommended by my family doctor.  Due to the huge number of women wanting to go through the procedure and the limited funding the government allocated to each clinic, the clinic had a random way of selecting the lucky couples each quarter to be fair so to speak.  We waited until July and was never selected.  We decided to bite the bullet and pay out of our own pockets (just under $30,000) as we are getting older.  It's now or never.  I have very low egg reserve and have pretty severe male factor fertility issues.

We’ve been thinking about IVF for over 3 years.  So what made me finally decide to do it?  The chickens made me do it, specifically the 4 mother hens and her 11 baby chicks (which by the way only 6 survived to date due to our dogs and that's another story).  There was something about being a mother hen that makes her completely fulfilled.  Okay I’m digressing so let me go back to what my intention was.

I have just received the more detailed report of the Day 3 embryos today and I find this stuff really fascinating. 

But first let me share what had transpired prior to today.

Pre-Ovarian stimulation (down regulation)

I was put on Estrace, Prometrium and Androgel for 21 days.  But on the day I was supposed to start the stimulation, doctor decided to cancel and re-start my down regulation because he found a cyst in my ovaries and didn’t want to take a chance.

Pre-Ovarian stimulation (down regulation) – 2^nd time

I took Marvelon (birth control pills) and Androgel for 23 days.  Marvelon side effects on me were headaches and moodiness.

Ovarian stimulation

This is the difficult part due to the painful daily self-administered injections on top of the daily internal probing and bloodwork at the clinic.  I was prescribed Menopur (to improve quality of eggs),  Puregon (to increase the number of eggs) and Thyroxine tablet.  Days 1-2, I took 150 IU of Menupur and 150 IU of Puregon.  Starting days 3-10, Puregon was increased to 225 IU. On days 7-9, I took Cetrotide to prevent early ovulation. On days 10 to 11, I took the ovulation trigger shot Ovidrel and Lupron.  Egg retrieval on day 12.

Egg retrieval

I was sedated while a tiny needle pierced through my ovaries to suck out the eggs.  This was done with an ultrasound probe (not sure if that’s the right term).  The actual procedure only took around 15 minutes. But in total it took around 3 hours including the prep part and the recovery period.  I was very sleepy and had a little discomfort after the procedure so I rested for the rest of the day.

 

Day 3 embryo

• 11 eggs retrieved
• 7 eggs mature
• 6 eggs fertilized
• 6 three-day embryos
• 1 eight-cell (ideal so far)
• 2 seven-cell
• 2 six-cell
• 1 four-cell (not looking good according to the embryologist)

This chart is a lot easier to read (I think)

Embryo	# of cells
1	8-cell (ideal)
2	7-cell
3	7-cell
4	6-cell
5	6-cell
6	4-cell (not looking good; can be a sign of abnormal embryo)

I’ve done some googling, and on day 3 most healthy embryos will be between 6 to 9 cells (with an ideal being 8 cells).  If they are lagging behind or growing too fast, they are a sign of an abnormal embryo.  Under 6-cell on day 3 embryos have about 10-15% chance of implantation success.  Those 6-9 cell embryo has about 20-30% chance of implantation. 

I’ve added a picture of what a 3-day embryo looks like.  It’s not mine.  I got it from the internet just to show what I mean.

By day 5, the embryos should be at the blastocyst stage and it will contain approximately 100-230 cells.

It’s after day 3 that can go a little scary.  I hope they all grow to healthy day 5 blastocysts.  Our clinic will only do Day 5 transfer.  In our case though, all viable embryos will be frozen at day 5 so it can be sent for PGS genetic testing and we have to wait for a couple of weeks to get the results.  I googled and Day 5 transfers is preferable because in natural conception cycles, embryos usually implant on days 5 or 6 after ovulation.  But there are other clinics that do Day 3 transfers.

At this point everything is in God’s hands.